For many hospitals, the holidays are a welcome chance to brighten patient rooms, nursing stations, and lobbies. Done well, decorations add warmth and comfort to a clinical environment. Done poorly, they add fuel, block exits, and create real risk for patients who cannot self-preserve.
The good news: you do not have to choose between festive and compliant. With a clear policy, a quick internal review process, and guardrails tied to NFPA 101 – 2024 (Section 19.7.5.6), you can support holiday cheer and stay survey-ready.
Start with a Simple Policy: Safety Manager Approval
Before the first wreath or garland goes up, set one clear expectation:
Any department that intends to decorate must contact the Safety Manager for approval at least 72 hours before decorations are installed.
That 72-hour review window allows your Safety or Environment of Care team to:
- Confirm the smoke compartment is fully sprinklered
- Review the materials (combustible vs. noncombustible, flame-retardant labeling)
- Check layout against egress, fire doors, and life safety features
It also gives you a defensible, standardized process when surveyors ask, “How do you control seasonal decorations in patient care areas?”
Key Guardrails from NFPA 101-2024, Section 19.7.5.6
For fully sprinklered smoke compartments in health care occupancies, decorations are permitted within limits. Your policy can translate the code into practical rules your staff can follow without needing to read the standard.
Here are the core elements to include.
1. Materials must be noncombustible or flame-retardant
- Decorations such as stockings, ribbons, garlands, and banners should be noncombustible or listed and labeled as flame-retardant.
- If materials are treated, use an approved fire-retardant coating and keep product labels or cut sheets on file.
2. No decorations on fire-rated doors
- Fire-rated doors are off limits: no wreaths, signs, wrapping paper, or vinyl clings.
- For non-rated doors, decorations must not interfere with the whole door operation or hardware.
3. Limit how much surface is covered
- In corridors and common areas, decorations should cover no more than 30% of the wall, ceiling, or door surface.
- In patient sleeping rooms, decorations should cover no more than 50% of the wall surface.
Translation: a few well-placed pieces are fine; floor-to-ceiling wrapping paper or “tunnel” effects are not.
4. Mount items securely and away from devices
- Art, photos, and similar items must be attached directly to the wall, door, or ceiling.
- Do not decorate or obstruct sprinklers, smoke detectors, pull stations, extinguishers, exit signs, or emergency lights.
5. No open flames
- Candles and any open-flame devices are not permitted.
- Battery-powered candles and LED lights are acceptable if cords do not create a trip hazard or obstruct egress.
Christmas Trees and Greenery: High-Impact, High-Risk
Holiday trees and greenery are often the most visible decorations—and the easiest way to get into trouble if not controlled.
A defensible policy will typically include:
Location
- Trees must be placed so they do not reduce corridor width or block exits, exit access, pull stations, or extinguishers.
No live or dry vegetation
- Live holiday trees, tree branches, pinecones, and other dry vegetation are not permitted anywhere in the hospital.
- These materials dry out, become highly combustible, and increase the fuel load in patient care areas.
No metallic trees
- Metallic trees are not allowed because of potential shock hazards with electric lights and added risk under fire conditions.
Artificial trees and wreaths
- Artificial trees and wreaths are permitted if they are labeled as flame-retardant or fire-resistant.
- Documentation from the manufacturer should be retained by Safety or Facilities.
Sample Holiday Decoration Message for Staff
Here is a posting-ready message you can adapt for internal communications, newsletters, or your intranet:
Subject: Holiday Decorations – Keeping Our Hospital Safe and Festive
As we approach the holiday season, many teams are planning to decorate patient care and work areas. Thoughtful decorations can brighten the environment for our patients, visitors, and staff, but we also need to maintain compliance with NFPA 101 – 2024 and our Life Safety and Environment of Care standards.
If your department plans to decorate, please contact the Safety Manager at extension XXXX at least 72 hours before decorations are installed.
When planning decorations in fully sprinklered areas, please follow these guidelines:
- Use noncombustible or listed flame-retardant decorations.
- Do not place decorations on fire-rated doors.
- Ensure decorations on non-rated doors do not interfere with door operation or hardware.
- Limit decorations to 30% of walls, ceilings, and doors in corridors and common areas.
- Limit decorations to 50% of the wall surface in patient sleeping rooms.
- Attach artwork and decorations directly to walls, doors, or ceilings—do not hang items from sprinklers or detectors.
- Do not block exits, exit signs, pull stations, fire extinguishers, or medical equipment.
- No open flame of any kind, including candles.
- No live trees, branches, pinecones, or other dry vegetation; no metallic trees.
- Artificial trees and wreaths must be labeled as flame-retardant and located so they do not impede egress.
Thank you for helping us keep our hospital both safe and festive for everyone.
Happy Holidays,
[Name/Title]
Bringing It All Together
The holidays do not have to be a clash between decorations and compliance. With:
- A clear approval process led by the Safety Manager,
- Guardrails grounded in NFPA 101-2024 Section 19.7.5.6, and
- Simple, memorable rules for staff, your organization can create warm, welcoming spaces that still respect the realities of defend-in-place care, limited mobility, and regulatory oversight.
Safe, festive, and survey-ready really can coexist.
